Provider Demographics
NPI:1518084342
Name:TOMAWIS, LINDY LEE
Entity type:Individual
Prefix:
First Name:LINDY
Middle Name:LEE
Last Name:TOMAWIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 E OLENTANGY ST
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43065-8467
Mailing Address - Country:US
Mailing Address - Phone:614-540-5330
Mailing Address - Fax:
Practice Address - Street 1:50 E OLENTANGY ST
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-8467
Practice Address - Country:US
Practice Address - Phone:614-540-5330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-25
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2391282374U00000X
OH007286225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH10599059099Medicaid